Provider Demographics
NPI:1871021733
Name:MEMORIAL AESTHETIC SURGERY CENTER
Entity Type:Organization
Organization Name:MEMORIAL AESTHETIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-799-8989
Mailing Address - Street 1:9230 KATY FWY STE 420
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7468
Mailing Address - Country:US
Mailing Address - Phone:713-799-8989
Mailing Address - Fax:
Practice Address - Street 1:9230 KATY FWY STE 420
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7468
Practice Address - Country:US
Practice Address - Phone:713-799-8989
Practice Address - Fax:713-799-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty